[Congressional Record (Bound Edition), Volume 146 (2000), Part 4]
[House]
[Page 5417]
[From the U.S. Government Publishing Office, www.gpo.gov]



                           PRESCRIPTION DRUGS

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 6, 1999, the gentlewoman from Michigan (Ms. Stabenow) is 
recognized for 60 minutes as the designee of the minority leader.
  Ms. STABENOW. Madam Speaker, I come today to talk about what I 
believe is one of the most challenging if not the most challenging 
issues affecting our seniors and affecting many families across the 
country. This was spoken to a while ago by the gentleman from Arkansas 
(Mr. Berry), who spoke very eloquently about the challenges of seniors 
related to the cost of prescription drugs.
  What we have seen over the years is a system that started in 1965 
under Medicare that has been a great American success story. In 1965, 
half of our seniors could not find insurance or could not afford health 
care insurance. Now we have a system for health care for seniors. The 
challenge before us is that health care has changed, the way we provide 
health care has changed. In 1965 we were predominantly providing health 
care in hospitals with surgeries, and the use of drugs was limited to 
the hospital.
  Today, we know that care has changed; and we see home health care, we 
see outpatient care, and a great reliance on new prescription drugs, 
wonderful medications that we are very pleased and proud to have 
developed in the United States. But at the same time we are seeing a 
growing disparity and a horrible situation for too many seniors who 
literally on a daily basis are deciding do I buy my food today, do I 
get my medications, do I pay the electric bill, how can I keep going 
and remain healthy and well by having access to my medications? Because 
Medicare does not currently cover the costs of prescription drugs.
  I rise today to urge my colleagues as quickly as possible, we are 
long overdue, in correcting this problem. We have economic good times. 
There is no reason that we cannot at this time get it right for 
Medicare, modernize Medicare, to cover the way health care is provided 
today; and that means covering the cost of prescription drugs. We are 
in economic good times, and I believe in these times we have 
obligations to pay our bills and pay our debts and to keep our 
commitments.
  One of the most important commitments that we have made to older 
Americans is Medicare, health care for them. Social Security is another 
commitment, health care for our veterans, all important commitments 
that we have made. But because of the challenge that I have heard from 
too many of my constituents all across Michigan, I began months ago 
putting together something called the Prescription Drug Fairness 
Campaign. I have asked seniors and families to share with me their 
stories, if they are having difficulty paying for their medications to 
call a hotline that I set up for them to share their stories with me, 
or for them to send me letters and copies of their high prescription 
drug bills so that we can put a real face and a name and a situation on 
this problem.
  This is not an issue made up by people on the floor of this House or 
by other politicians. This is an issue that is real for every senior 
and every family in this country. One of the things that disturbs me 
the most is the fact that we see such a disparity in pricing. As the 
gentleman from Arkansas mentioned earlier, we have a situation where if 
you go to another country, in my State we are right next to Canada in 
Michigan, I included a bus trip, I invited a number of seniors to join 
me, to go across the Ambassador Bridge from Detroit to Windsor; and we 
dropped their costs by 53 percent by crossing the bridge.
  There is something wrong when there can be such a disparity. And when 
you add to that the fact that we are precluded by American law from 
bringing those drugs, mail order or bringing those medications 
routinely across the border without seeing a Canadian physician first 
and going through the Canadian process, we cannot reimport those drugs 
back into the United States, American-made FDA approved, because of 
protections that were put into the law in 1987 to protect our own 
pharmaceutical drug companies who are making the drugs here and 
benefiting from our research and development and the institutions that 
we have, the tax system we have that provides tax incentives and tax 
write-offs, which I support, I think it is important and good public 
policy for us to have an R&D tax credit, I think we need to keep it; 
but they benefit from that, sell to other countries, and then people 
are not even allowed to bring that back, to reimport it, without going 
through the process of seeing a Canadian physician and going through 
the Canadian health system.
  I have also done other studies in my district that have shown that if 
you have insurance, if you have an HMO or other kinds of insurance, you 
are paying half on average what an uninsured senior or uninsured person 
is paying for their medical care, for their medicines. So we see 
seniors who use two-thirds of the medications in this country who do 
not have insurance and then because others get discounts because they 
are negotiating group discounts, they do not get those discounts, so 
they not only do not have insurance but they pay more on top of that, 
paying twice as much as somebody with insurance. It is crazy.
  We have done another comparison as some others of my colleagues have 
that have shown that there are medications that are provided for 
animals as well as for people where in those cases where there is 
arthritis medication, heart medication, high blood pressure medication, 
we compared eight different medications to find that the same name, the 
same drug, the same quality controls and it costs half if you go to get 
it for your pet than it does for you to walk into the pharmacy, and we 
see the same medication. There is something wrong with this picture. We 
need to make sure that Medicare covers costs of prescription drugs, we 
modernize it to cover the way health care is provided, and then we need 
to get busy to make sure that we are lowering the cost of prescription 
drugs for all of our families.
  I would like to share this evening three different letters that I 
have received from people around Michigan sharing their stories. I have 
made a commitment to the seniors of Michigan that I will come to this 
floor, I will share stories once a week every week until we fix this. 
Let me share with my colleagues this evening starting with Delores 
Graychek from Indian River, Michigan. Delores writes and sends me 
information as follows:
  ``I heard you talk on TV on January 26 and something does need to be 
done to help all of us out here that's on seven or eight medications 
like I am and have no help to pay for them. I picked up six of my seven 
meds yesterday. The total came to $274.78. That is more than my Social 
Security check. More than my Social Security check. Each month we get 
deeper in debt and soon we will be like a lot of other older people. We 
won't have anything left. We also are paying on hospital bills for me. 
I had open heart surgery last November. So by the time all of our bills 
come in, our Social Security checks are gone. I think it's a shame our 
golden years aren't golden after all. Thank you for what you're trying 
to do.
  Truly, Delores Graychek, Indian River, Michigan.''
  I want to thank Delores. She is right. Her golden years should be 
golden. It is up to us in the Congress to step up and to get it right. 
If we do not do this in economic good times, we never will. Now is the 
time to step up and cover prescription drugs under Medicare.
  Let me cover another letter that I want to thank Joseph and Ethyl 
Korn from Marquette, Michigan, in the great upper peninsula of Michigan 
for writing and sharing this with me.

       Dear Congresswoman Stabenow:
       My husband and I have an enormous hardship with our 
     prescription bills. Joe, who's a World War II veteran, fought 
     to save our country. He has Parkinson's, mini-strokes, 
     diverticulosis and deep depression. I have high blood 
     pressure and I take my medicine, when I can afford it, 
     including Premarin for my bones. Here is our prescription 
     bill for what we can afford, and you can see I don't get all 
     of mine. Oh, yes, I also have glaucoma and I need eye drops. 
     This is Joseph and Ethyl M. Korn at the Snowbury Heights 
     Retirement Home in Marquette, Michigan.

  Mr. COBURN. Madam Speaker, will the gentlewoman yield?
  Ms. STABENOW. I yield to the gentleman from Oklahoma.
  Mr. COBURN. I think it is important for us to know, the lady you just 
described is on Premarin which in this country, a generic has been 
waiting to be approved by the FDA for 5 years to sell at 20 percent of 
the price of what she is paying right now, the exact same drug.
  Ms. STABENOW. I would reclaim my time and thank my colleague for that 
information and would be happy to join with him in the issue of generic 
drugs, as well, as we look at how we lower the costs of prescriptions, 
because there are a number of different strategies that need to happen 
today, that need to address how we bring more competition with 
generics, how we allow the prices to go down because we have Medicare 
negotiating a group discount.
  Right now seniors do not have anybody. If they do not have private 
insurance, a senior citizen today does not have anybody negotiating a 
group discount for them while others do have people, whether it is 
insurance coverage or their HMO.
  Let me also share the information: I do have enclosures that I 
appreciate Joe and Ethyl sending me their expenditures from January 1, 
1999, until November 6, 1999. Mr. Korn's total prescription drug cost 
for this 10-month period was $1,515.36. The total cost for Ethyl, who 
admits she cannot afford everything she needs, was $324.02.

                              {time}  1845

  One of my concerns I hear from friends of mine who are physicians are 
concerns that people are not purchasing what they need, or that they 
are taking it the wrong way. I had a physician in Michigan join me at 
an event and share the fact that he had lost a patient because she was 
taking her medication every other day, instead of when she needed it, 
every day.
  I have had stories of individuals talking to me about cutting their 
pills in half so they will last longer. This does not make sense. In 
our country, with the greatest innovations, the greatest health care 
innovations, the best research, we need to make sure that our seniors 
have access to these new medical options that are available, and are 
not picking between their food, paying their bills and their medicines, 
and that is what is happening with too many people today.
  I want to share one more story, and that is Donald Booms from Lake 
City, Michigan. I very much appreciate Mr. Booms sharing his story with 
me as well.
  Dear Congresswoman, recently I saw a story on TV about seniors not 
having insurance for prescription drugs. I am one of those people. I 
take three prescriptions daily and they cost about $200 a month. My 
wife is currently on Blue Cross. She goes on Medicare in April of this 
year, which means she, too, will be without insurance for prescription 
drugs. She is a diabetic and takes seven prescriptions a day. Her costs 
will be about $260 a month. Together we will be paying nearly $500 a 
month for our prescription drugs. Together our Social Security checks 
are about $1,100, minus $300 for Medicare and Medigap insurance 
payments, and we have $800 a month to live on. There surely does need 
to be something done with prescription drugs for seniors.
  Thank you, Mr. Booms. There is something wrong when you are having to 
take $500 out of $800 a month in order to pay for your medications. 
Once again we are talking about a story of a couple on a fixed income, 
prior to retirement having access to health care and coverage, going 
into Medicare and retiring, and then finding themselves in the 
situation where they are taking the majority of the money that comes in 
every month just to pay for their medications.
  I have hundreds of stories like this, hundreds of stories of people 
who are struggling every day to pay for their medications and to remain 
healthy.
  When we took our trip to Canada, from Detroit to Windsor, there was a 
gentleman on the bus named George who is 79 years old, almost 80 years 
old. He continues to work in order to pay for $20,000 a year in 
prescription and other health care costs for his wife. His wife is on 
16 different medications, and he continues to work so that she can 
``live,'' as he puts it, so that she can remain with him. As he was 
telling me, there were tears in his eyes talking about how he had to 
keep working so that he could make sure his wife would remain with him 
and would be alive.
  Another gentleman shared with me the fact that he takes one pill a 
month, and, because of our wonderful new innovations, which we are very 
appreciative of, that one pill allows him not to have open heart 
surgery, but the one pill costs $400.
  When a pharmaceutical drug company comes forward and says that in 
order to be able to cover the cost of prescription drugs and address 
these high costs for seniors we would lose our research, that is just 
baloney. Twenty cents on every dollar that Mr. Booms or that the Korns 
are paying, 20 cents on every dollar is going to research. What we are 
seeing today is a whole new effort of advertising so that, as my 
colleague who talked about generic drugs said, the companies want to 
make sure we ask for the brand name. So we are paying more for 
advertising than for research.
  So the reality is there is a way to get this right if we have the 
political will to do it. I believe, and I want to call on my colleague 
from Maine in a moment who has been such a leader as well in this 
issue, but I believe if we can solve Y2K, because it was a serious 
issue and we could not afford to let the lights go out and could not 
afford to let the computers go down, and brought all the American 
ingenuity together to fix what needed to be fixed, we did it. The 
lights were on January 1. Why can we not bring this same American 
ingenuity to help our seniors? Why can we not lower the cost of 
prescriptions and modernize Medicare to get it right? We can. I am 
going to be down here every week until we do it.
  I yield now to my good friend the gentleman from Maine (Mr. Allen).
  Mr. ALLEN. Mr. Speaker, I thank the gentlewoman for yielding, and I 
want to thank the gentlewoman for her leadership on this issue. This is 
something that she and I have been working on now for, well, pretty 
close to 2 years, pretty close to 2 years, trying to bring the stories 
of these people, seniors all across this country and others who do not 
have prescription drug insurance, to the attention of this Congress. 
Although the issue is rising in terms of its coverage around the 
country, this Congress has yet to act.
  I thought what I would do is talk about a few stories. A few of the 
stories were the stories that basically I heard when I first began, and 
they were simple stories, such as a retired firefighter in Sanford, 
Maine, standing up and telling me I spend $200 a month now on my 
prescription medication. My doctor just told me I need another 
prescription. It costs $100 a month, and I am not going to take it, 
because he could not possibly afford it.
  Or the woman who wrote to me in July of 1998, the first of many, with 
a long list of her prescription drugs. She said in her letter here is a 
list of the medications that my husband and I are supposed to take. The 
bottom line was $650. She said here is a copy of our two Social 
Security checks, which is all the monthly income we have. The bottom 
line was $1,350.
  That math does not work. You cannot have people who are taking in 
$1,300 a month total income, expected to spend $650 of that for 
prescription drugs alone. They have got rent, food, heat, and 
utilities; and it does not work.
  I have had women write to me and say I do not want my husband to 
know, but I am not taking my prescription medication because he is 
sicker than I am and we cannot both afford to take our medication.
  It should not be like that in this country, and there is no reason 
why it should, but the truth is that 37 percent of all seniors have no 
coverage at all for prescription medication. Another 16 percent are in 
these wonderful HMOs that were supposed to provide free prescription 
drug coverage, and every year the benefits go down, the cap goes down, 
the premiums go up, and people are left paying more and more of their 
prescription coverage out of their own pockets.
  About 8 percent of people have Medigap prescription drug coverage, 
but often the cap is about $1,000 a year. That does not do much good 
for a lot of seniors in this country, who have several thousand dollars 
of prescription drug expenses in any one year.
  Let me tell you about what we did in my district. I sent out a 
newsletter devoted entirely to health care. It dealt with veterans' 
care; it dealt with small businesses who were having trouble paying 
their premiums. It dealt with the veterans' health care, it dealt with 
seniors, it dealt with prescription drugs.
  We got back 5,269 respondents, actually somewhat more than that. But 
we had a question in a questionnaire attached to this newsletter, and 
the question was, one of them, do you or your family member take a 
prescription drug on a regular basis? 4,089 people said yes. Of those 
4,089, 1,726 said yes to the question do you have any difficulty paying 
for the drugs you or your family need? The truth of the matter is, 
people cannot do it.
  We got back comments in response to those questionnaires. Here is 
one. A woman writes, ``Dear Mr. Allen, do I need help. My Social 
Security check is $736 a month. My medication is $335 to $350 a month. 
My Blue Cross, the supplemental insurance, is $106 a month.''
  So she did the math. $736 minus $106 for Blue Cross, minus the $350 
for medication, left her $280 to live on. And she said ``my husband 
passed away last July.''
  Another woman wrote, ``I am a site manager here at an elderly housing 
project. I have approximately 110 tenants. We are in low-income 
housing. It is a crime to see how many people forego their groceries to 
buy a prescription or forego the prescription so they can eat. Several 
of my folks here do not have any supplemental insurance and won't go 
for Medicaid, as they think it is welfare.
  ``Last March, my husband had an aneurism and had to have surgery. He 
survived it and was given 2 prescriptions. When I got to the pharmacy I 
found they came to $300. Needless to say, I didn't have that kind of 
money. I called his doctor. My doctor is very kind and gives me samples 
when he can. Otherwise, I would not have them, as we just don't have 
the financial income to cover everything.''
  Another woman writes, ``Since I am self-employed, I cannot afford the 
expensive health plans, and since I am a diabetic, I should have 
medication, but I cannot afford medication because that is too 
expensive. I can't even afford the doctor because they are also too 
expensive. You have to see a doctor to get the medication. Hopefully 
there is an answer for me and people like me. I have a question: How 
can Canada sell the same medication for half the price? They must be 
doing something right.''
  One more story. ``At age 64,'' age 64, remember this, just before 
Medicare, ``at age 64 my wife is severely disabled by rheumatoid 
arthritis and is heavily reliant on at least 5 expensive prescription 
drugs. Over the past 3 years her total costs for those drugs has 
averaged just over $7,500, of which I have paid just over $2,000 out-
of-pocket each year. I am fortunate to be able to cover that cost 
without sacrifice, but I am very concerned about what our situation 
will be when my wife turns 65, is forced to give up the private major 
medical policy which I now buy for her, and has to rely on Medicare and 
Medigap.''
  When she is over 65, she is on Medicare and she no longer has 
outpatient prescription drug coverage, and the Medigap policies that I 
mentioned earlier typically have caps of $1,000, $1,200, or, at most, 
$1,500.
  The truth is, the most profitable industry in the country is charging 
the highest prices in the world to people in this country who do not 
have health insurance that covers their prescription drugs. Twelve 
percent of the population is seniors. They buy 33 percent of 
prescription drugs. In my State of Maine, because there is no 
significant amount of managed care, I can tell you that just about 50 
percent of the seniors in Maine have no coverage at all for their 
prescription medication, no coverage at all, and we know that over 80 
percent of seniors take some prescription drugs, 83, 85 percent, 
something like that. So they are all taking prescription drugs.
  In this context, what we have done on the Democratic side of the 
aisle is we have a plan, the President's plan for a Medicare 
prescription drug benefit, a start to help cover prescription 
medications for seniors who do not have the money to afford it right 
now.
  We also have a bill that I have offered, and the gentlewoman has been 
a cosponsor from the beginning, which would provide a discount. If 
there are people who think a Medicare prescription drug benefit is too 
expensive for us now, we can do a discount, no new bureaucracy, no 
significant Federal expense, but a discount of up to 40 percent in the 
prices that seniors pay today for their prescription medications.
  The Republicans in this House will not adopt either proposal, will 
not bring either proposal to the floor. What we hear this week is they 
are about to bring a proposal forward that is great for the 
pharmaceutical industry, but it is a disaster for seniors, because it 
relies on private insurance.
  I would ask my friends on the Republican side of the aisle, why is it 
so difficult to strengthen Medicare? Why is it so difficult to update 
Medicare and add a prescription drug benefit?

                              {time}  1900

  The private sector plans that are out there have prescription drug 
benefits: Aetna, Signa, United. The major private health care plans 
around this country have prescription drug benefits. Why not Medicare? 
Is it that hard?
  The answer is, it is not that hard. We could do it, and we could do 
it now. We could give relief to the seniors who have been writing me, 
who have been writing the gentlewoman, who have been talking to 
Democrats all across this country. It is a national scandal that we do 
not do something about it, and we must before we adjourn this fall.
  I just want to say to the gentlewoman from Michigan (Ms. Stabenow) 
how much I appreciate the gentlewoman's determination, her persistence, 
her leadership on this issue. She is really doing us all proud. I thank 
the gentlewoman very much.
  Ms. STABENOW. I thank my colleague, who has been a terrific leader, 
really a pioneer, in this effort. He has been down here making the 
case.
  As the gentleman says, there is more than one strategy. There is a 
discount by allowing pharmacies to purchase directly from the Federal 
price schedules. There is opening up the borders to allow people to 
bring drugs back in, or to do mail order.
  Fundamentally what I believe is the long-term solution that we have 
to come to is taking the health care system for our seniors in the 
country today and modernizing it to cover the costs of medications. 
That is the way health care is provided today. We have an opportunity, 
a once-in-a-generation opportunity where we have choices we can make 
with a good economy.
  In the long run, this saves money by making sure that we keep people 
healthy and out of the hospital, and allow them to be able to continue 
to live vigorous lives and be able to have their health care needs met. 
It makes no sense not to do it right. I want to thank the gentleman for 
joining me.
  Mr. Speaker, I yield to the gentleman from Michigan (Mr. Stupak), who 
has been a terrific leader in Northern Michigan, in the Upper 
Peninsula. He has been doing studies and meeting with people weekly to 
hear their concerns. I know the gentleman shares our concern and 
determination.
  Mr. STUPAK. Mr. Speaker, I thank the gentlewoman for her leadership 
on this issue.
  I was in my office doing some work and I heard the gentlewoman's 
statements, and statements the gentlewoman has received from around 
Michigan. She has been a leader around the Nation to try to get prices 
lower for all our constituents in Michigan. Some have been from 
Marquette Michigan, the area I represent.
  I certainly share the gentlewoman's sentiments. In September of 1998, 
we had the Committee on Government Reform also do a study in my 
district, which as the gentlewoman said is the Upper Peninsula, 
Northern and lower Michigan.
  We found that the most favored customers and the big HMOs, those who 
have insurance coverage, pay about half of what an uninsured senior 
would have to pay for prescription drug coverage. Not only is there 
inherent discrimination here, where we make those who can least afford 
it pay the most because they do not have the purchasing power behind 
them of a big HMO or a big insurance company.
  What we have found also in further follow-up studies, and I know the 
gentlewoman has mentioned it tonight, in Mexico, Canada, the same 
drugs, the same companies, the same number of pills in that vial, and 
they pay 50 to 60 percent less.
  Our seniors go to Canada up in our neck of the woods, or if they are 
in the South, they go to Mexico and get it for half the price.
  I saw an article recently in Congress Daily where they said, Well, 
those countries do not allow us to put our true cost out there, and 
therefore, those countries have price controls over their prescription 
drugs. But in the United States, since we do not make any kind of 
controls or try to rein in these pharmaceutical companies, they charge 
basically whatever they want.
  When we look at these studies, take the study from my district in 
1998, they show the return on that investment on that prescription drug 
for those pharmaceutical companies, a 26.7 percent profit.
  When inflation is 3 percent, their profit margin for that year, 1997, 
the most recent statistics we had, was 26.7 percent. For total profit 
after all the advertising, after all the research, it was $28 billion.
  I do not mind them making a profit, but I do not think in this time 
of low inflation we should have 26.7 percent profit or $28 billion in 
profits and not help out those seniors who really need the help.
  Take a look at it. I have a letter here from a lady from my district. 
I am going to be doing town halls for the next two weeks, and the 
gentlewoman will be also, in Michigan. We are going to hear a lot more 
about this.
  She writes, ``Dear sir, my only income is social security, a check of 
$685. I live in a L'Anse housing apartment. I pay $147 a month. I had 
to sell my car. I really do need the help.'' She sends me her 
prescription drugs. There is $54.39, $50.51, $15.53, $12.74. These are 
monthly. Add that up.
  Here is another one from another lady from L'Anse. She says, ``Dear 
sir, I am enclosing receipts for medicine I had to take for pneumonia. 
My husband died December 11, 1998, and I have $634 to live on for the 
month. I pay $137.64 for Blue Cross insurance. I am 73\1/2\ years old 
and I still work, so I can continue with Blue Cross-Blue Shield and 
prescriptions. But even with the allowance, I still have to pay about 
$20 for each prescription I take, and I do it for a month. So even 
though I have Blue Cross-Blue Shield, I still have to pay another $80 
in co-pay. I ask you, I don't have enough to go around. I sure hope 
something can be done on the price of prescription medicine.''
  Again, she made me copies from Primo Pharmacy of all of her 
parmaceuticals.
  Here is another individual from Cheboygan, Michigan. ``In response to 
your AARP article concerning drug prices for seniors, I am 88 years 
old, a widow, living on a social security benefit of $814 a month. I am 
enclosing receipts for my drugs for just 1 month, every month. Some 
months it is more. The total is $446.36 a month. Seniors really need 
help with drug prices.'' She signs her letter.
  The issue here is, seniors do need help with drug prices, with the 
costs of their drugs. There are three bills: the Allen bill from the 
gentleman from Maine, which takes the purchasing power of the Federal 
government to try to drive down the prices of prescription drugs for 
seniors who do not have any type of insurance coverage; the Stark bill, 
which actually says, make it part of Medicare, have universal service. 
There is the President's bill, which does a little bit of both.
  I know the Republican party will be bringing forth a bill, and I look 
forward to it, but I hope they understand one thing. We have to stop 
the price discriminatory practices by the pharmaceutical companies and 
make it universal coverage. In this country, there is no reason why 
not.
  In my district, about 40 percent of seniors do not have any 
prescription drug coverage. Why should they pay twice, twice as much as 
someone who happens to have a prescription drug coverage or is part of 
a large HMO?
  As the gentlewoman knows, in the Upper Peninsula of Michigan there 
are no HMOs. In lower Michigan there is now one left. A very small part 
of my district can take advantage of an HMO to get prescription drug 
coverage.
  Again, we do not mind them making a buck, but when their return is 
26.7 percent, that is better than the market right now. Even after 
paying all the research, all the advertising, and whenever we open up 
the magazine it is full of advertising for this drug and that drug, 
they are still making $28 billion a year. We do not mind a profit, but 
do not gouge our uninsured seniors to make a profit.
  The Democrat party would like to see universal coverage, and stop the 
predatory price discriminatory practices of the pharmaceutical 
companies.
  I must say, we have to thank the pharmacists throughout the State who 
have brought this to our attention and have helped us in these studies 
to show us what they have to pay. It is not their fault. The local 
pharmacist is doing the best they can. They get the price. If the 
customer is with Blue Cross/Blue Shield, they pay one price, with Aetna 
they pay a different price, with the Federal system they pay a 
different price. That is passed on from the pharmaceutical companies. 
The markup is very, very small, 1 or 2, 3 percent at most. These are 
the prices being set by the pharmaceutical companies.
  I think in this day and age there is no reason why we cannot have 
prescription drug coverage for our seniors, especially those who, like 
these widows that I have brought these letters from, they have written 
to me, they did not have insurance policies. They did not have 
insurance plans. Their husbands are deceased. They live on social 
security. That is it.
  No one would devise a Medicare plan nowadays without prescription 
drugs. Prescription drugs are wonderful. They save lives. We should 
have it. We should have it for everyone.
  I want to thank the gentlewoman for her leadership. I look forward to 
working with her over the Easter break. I am sure we will be doing more 
town hall meetings. I am sure we will see more and more discussion 
about prescription drug coverage. But I thank the gentlewoman for 
having this special order tonight. It is an issue very near to the 
seniors in my district and throughout this country.
  We reach out to our Republican friends. Together we can solve this 
problem. I hope that we will be joined by our friends across the aisle 
to put forth a program to just use the purchasing power of the Federal 
government under the Federal supply service, pass that on to those 
uninsured seniors, and we can cut the price in half for those seniors. 
That is not asking too much. I think we could do that. I hope they will 
join us with that.
  Ms. STABENOW. I thank the gentleman very much for his efforts. I know 
this adds another dimension in our rural parts of the country in 
Michigan, up north in the UP, where it is more difficult to get to a 
hospital or other facilities as well. We need to really be 
strengthening our home health care and medications so people can be 
living at home and living with family, and having the opportunity to be 
independent. They have longer distances as well to drive, and it 
complicates health care provision, I know.
  I want to thank the gentleman for all of his work. He is at the front 
end of what is happening, and I want to thank the gentleman from 
Michigan (Mr. Stupak) for that.
  Mr. Speaker, let me just stress again that we have within our means 
the ability to solve this problem. Medicare was started in 1965 because 
half of our seniors could not find insurance or could not afford it. It 
has now become a great American success story of having a promise that 
every senior has some basic health care available to them once they 
reach age 65 or if they are disabled.
  What we have today, though, is a false promise, because we cannot 
provide the kind of health care or access to the kind of health care 
that is practiced today. That is predominantly through our prescription 
drug strategies for providing health care. More and more of health care 
is provided through medications, and if the health care plan does not 
cover medications, people are in very tough shape.
  Our goal is to modernize Medicare to cover the way health care is 
provided today. That is it. We are hoping that our colleagues will want 
to do that. My greatest fear is that there will be proposals put 
forward to subsidize the high cost, help seniors pay for the high 
prices, but not do anything to get a handle on the prices or bring some 
accountability to those prices.
  We need to have somebody negotiating on behalf of seniors through 
Medicare to get the same kind of group discounts that people do if they 
go through a private insurance company or through an HMO. That is what 
can happen. The purchasing power of Medicare can make that happen, if 
we act this year. We have the ability to act, we have the resources to 
act, and we can do that on behalf of all of our seniors if we have the 
political will to make it happen. We did it with Y2K and we can do it 
with Medicare and prescription drugs for our seniors.
  Mr. Speaker, I know the gentlewoman from Ohio (Ms. Kaptur) has been 
from northern Ohio, bordering right on Michigan, and we have a lot of 
ways in which we work together fighting for our seniors, for our 
families. She has also been a champion on this issue, as well.
  I will just say in conclusion that we are going to keep going every 
week, every week, every week, until this gets fixed, because we can do 
no less for our seniors.

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